Deep or partial caries removal: which is best?
METHODS
Searches for studies were made using the databases: Medline, Evidence-based Medicine Reviews, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials and OVID's Database of Abstracts of Reviews of Effects.


METHODS
Only studies reported in English with human participants were included. Randomised controlled trials (RCT) and relevant observational studies were included. No other inclusion or exclusion criteria are described.


METHODS
A formal data extraction process is not described and a qualitative description of the included studies is provided.


RESULTS
Ten articles reporting six studies were included. The results of three RCT, one with a followup period of 10 years, provide evidence supporting the practice of leaving behind infected dentine, the removal of which would risk pulp exposure. A number of other studies show that cariogenic bacteria, once isolated from their source of nutrition by a restoration of sufficient integrity, either remain dormant or die and thus pose no risk to the health of the dentition.


CONCLUSIONS
There is substantial evidence that, for caries management, it is not necessary to remove all vestiges of infected dentin from lesions approaching the pulp.
Ricketts
David
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Department of Restorative Dental Care and Clinical Dental Sciences, University of Dundee Dental School, Dundee, Scotland, UK.